Perry asks Texas delegation to fight for flexibility on Medicaid

In advance of a Washington speech expected to touch on health care reform, Gov. Rick Perry sent a letter to the Texas congressional delegation Thursday reiterating his opposition to the federal Affordable Care Act and its expansion of Medicaid, but urging Texas members of Congress to support the Medicaid reforms outlined in U.S. Rep. Paul Ryan’s recent budget proposal.

While continuing his harsh criticism of the Obama Administration’s health care reform measure, Perry told the delegation that states need more flexibility in administering Medicaid.

“With increased flexibility, my goal is to better serve Texas’ most needy, while promoting a sense of personal responsibility and ownership in an individual’s own healthcare,” he wrote.

“I urge you to help your home state by securing flexible funding so we may tailor our program to specifically meet the needs of our citizens in a fiscally responsible manner.”

Specifically, he wants Texas to be permitted to require co-pays and test assets to ensure that only the most needy are helped. He also advocated health savings accounts, “providing patients more control over health care spending,” and said the state should “promote the use of existing private coverage and employer-spons0red coverage.”

He chafed at current rules that require states to seek federal permission before making any changes to their Medicaid programs.

“Whether it is with the current administration or future administrations, we must make the era of ‘Mother may I’ a thing of the past,” he wrote. “Freedom and flexibility should be afforded equally across all states.”

Perry has come under significant pressure to accept the federal plan for expanding Medicaid, which affords the state a 20-to-1 match in the first three years. He and other legislative leaders have expressed fear that the federal government would significantly reduce its match after Texas extended healthcare to an estimated 1 million low-income adults.

But Medicaid expansion has support among health care providers and local governments whose taxpayers absorb the cost of paying for health care for the poor. Harris County Judge Ed Emmett has strongly endorsed Medicaid expansion to reduce the burden on local taxpayers.

Recently, key lawmakers have endorsed negotiating with the federal government to design a “Texas-style” Medicaid program. Perry’s letter gives clues to what he could support in any compromise solution.

Perry is speaking Thursday afternoon to CPAC, the Conservative Political Action Conference, and is expected to address Medicaid.